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What causes increased creatine kinase level in blood?

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General & Family Physician
Practicing since : 2004
Answered : 607 Questions
My daughter is almost 18. Back in 2009 we discovered high CK, ALT, AST and Aldolase. She is asymptomatic. We tested these levels a few more times in 2010, 2011, 2013 and now in Dec 2017. Her levels are higher now, but she still remains completely asymptomatic (knock on wood). She is on Varsity dance team and works out almost every day--does head XXXXXXX etc. I know you can't evaluate her physically, so please assume she doesn't have any symptoms. She was evaluated by a rheumatologist, then passed to a neurologist and after many many genetic tests, was told that unless her numbers (at that time CK was 908) more than doubled, we could go on with monitoring but no other tests needed. In 2010 she had an EKG, MRI on hips and leg, ultrasound of liver. All were normal. Currently: CK-1142, AST-152, ALT-137. Aldolase was high in the past as well (last checked 19.2 but don't have new level yet). Pediatrician suggested we possibly see a gastroenterologist next. But given the CK level being elevated, doesn't that suggest leaking muscle enzymes instead of liver? Any suggestions??
Thank you!
Mon, 7 May 2018 in Medicines and Side Effects
Answered by Dr. Zotaj Antoneta 2 hours later
Brief Answer:
Several possible causes discussed and recommendations given

Detailed Answer:
Thank you for asking at healtcaremagic.

I carefully read your question. As i see by your explanation the most increased is CK level which is almost 4 times the upper threshold that generally literature recommends examinations.

There are several causes of increased CK. As i see your daughter does a lot of sports and physical activity might increase the CK several times above the norm and in some cases up to 30 times and it takes a week to go down to norm after no exercise.
So i would say that your daughter needs to checkd CK when she has at least one week without exercise (at least to test it) and if the values decrease significantly it is purely related to exercise. I would recommend this first as this is easy to do and prevents having other more rare and expensive tests.

If the values still are way above 325 than she might need to have these tests done (if she has not had them done
- TSH (to check thyroid function)
- check for celiac disease
- CK electrophoresis to check for macro CK
- EMG and nerve conduction tests to rule out muscular disease

She seems to have seen a neurologist and a rheumatologist and i hope she has done the needed tests to rule those out as these can also cause increase in CK.

If she takes any tablet regularly, even supplements or any kind of tea this might need to be checked if these cause changes in CK also.

I hope this gives you some clues and helps you better understand but please feel free to reply in case anymore clarifications are needed on this.

Kind regards,
Antoneta Zotaj, MD

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